Healthcare Provider Details

I. General information

NPI: 1750126496
Provider Name (Legal Business Name): KADY PALMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 06/25/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 ASHLEY AVENUE ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON SC
29425
US

IV. Provider business mailing address

169 ASHLEY AVENUE ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON SC
29425
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-8972
  • Fax:
Mailing address:
  • Phone: 843-792-8972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL92681
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: